Scoliosis: staying ahead of the curve

Scoliosis, which affects more than 6 million Americans, can cause physical deformity, reduced function and discomfort. The condition can also lead to serious health problems later in life if left untreated. However, all of this can be avoided if scoliosis is detected early, before it has a chance to develop.

Scoliosis is a condition involving abnormal sideways curvatures of the spine that occurs most often during the growth spurt just before puberty. Girls are 10 times more likely than boys to get it, with 3 percent of children under age 16 developing the most common form. On an X-ray, the spine of a person with scoliosis looks more like an "S" or a "C" than a straight line.

"Just as there is no cure for scoliosis, there is also no way to cause it," explains
Dr. Matthew Vance, a pediatric orthopedist at
Sharp Rees-Stealy. "This means that neither heavy backpacks nor bad posture has any bearing on whether a child develops scoliosis."

Although doctors don't know what causes scoliosis or how to cure it, they do know that early detection can prevent the painful spinal deformity that can cause pain, physical impairment and other health issues later in life. For that reason, many states require schools to screen students for scoliosis. California schools are
required by law to screen girls in seventh grade and boys in eighth grade.

Signs of scoliosis may or may not be visible, and it is possible for curves to progress before a child has undergone school screening. Therefore, parents should ask their pediatrician to screen children (especially girls) regularly throughout their late childhood and teen years.

If scoliosis is suspected, your doctor will order X-rays of the entire spine. If scoliosis is present, the doctor will measure the spine's curves and provide a number, in degrees, to help describe the scoliosis.

Most of the time, adolescent scoliosis is mild enough that it requires no medical treatment. If the curve is determined to be mild, the doctor will probably "watch" it by ordering X-rays every 4 to 6 months. If the curve has progressed, the doctor may recommend bracing.

Research shows that bracing is the best way to prevent curvatures from progressing in adolescents. In 2013, a
large multicenter study was halted because researchers found bracing so effective in preventing curves from advancing. The rate of treatment success was more than 70 percent after bracing, and the benefit increased with longer hours of brace wear.

If a curve is severe, or the patient is at high risk of continued worsening even after they finish growing, doctors will likely recommend surgery. Curves that grow very large may cause pain, limit certain body functions or movements, and cause difficulty or discomfort with breathing later in life.

According to Dr. Vance, "If children are screened regularly for scoliosis, chances are that curves will be caught before they require surgery. This could afford us the opportunity to control progressive curves with a brace, potentially avoiding a large surgery in adolescence. If you have questions about scoliosis, treatment options or screening your child, contact your doctor."